Welcome to CommunityChiroWellness.com. Information on this page includes our Notice of Privacy Practices which details how we protect the protected health
information of our patients.
NOTICE OF PRIVACY PRACTICES
Community Chiropractic & Wellness Center
2352 S Commerce Rd
Walled Lake MI 48390
Office Phone: 248-960-0520
Effective Date: March 11, 2016
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW THIS NOTICE CAREFULLY.
This Notice of Privacy describes how we may use and disclose your Protected Health Information (PHI) to carry out treatment, payment or health care operations (TPO) and for other purposes that are permitted or required by law. It also describes your rights to access and control your PHI. “Protected Health Information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health condition and related health care services.
USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION
Treatment: We may use and disclose your personal information to provide you with treatment or services. For example, we may use your health information to prescribe a course of treatment or make a referral. We will record your current healthcare information in a record so, in the future, we can see your medical history to help in diagnosing and treatment, or to determine how well you are responding to treatment. We may provide your health information to other health providers, such as referring or specialist physicians, to assist in your treatment. Should you ever be hospitalized, we may provide the hospital or its staff with the health information it requires to provide you with effective treatment.
Payment: We may use and disclose your health information so that we may bill and collect payment for the services that we provided to you. For example, we may contact your health insurer to verify your eligibility for benefits, and may need to disclose to it some details of your medical condition or expected course of treatment. We may use or disclose your information so that a bill may be sent to you, your health insurer, or a family member. The information on or accompanying the bill may include information that identifies you and your diagnosis, as well as services rendered, any procedures performed, and supplies used. Also, we may provide health information to another health care provider, such as an ambulance company that transported you to our office, to assist in their billing and collection efforts.
Health Care Operations: We may use and disclose your health information to assist in the operation of our practice. For example, members of our staff may use information in your health record to assess the care and outcomes in your case and others like it as part of a continuous effort to improve the quality and effectiveness of the healthcare and services we provide. We may use and disclose your health information to conduct cost‐management and business planning activities for our practice. We may also provide such information to other health care entities for their health care operations. For example, we may provide information to your health insurer for its quality review purposes.
Other Permitted and Required Uses and Disclosure will be made only with your consent, authorization or opportunity to object unless required by law. You may revoke the authorization, at any time, in writing, except to the extent that your physician or the physician’s practice has taken an action in reliance on the use or disclosure indicated in the authorization.
Business Associates. Paul Eckley, D.C. sometimes contracts with third‐party business associates for services. Examples include answering services, transcriptionists, billing services, consultants, and legal counsel. We may disclose your health information to our business associates so that they can perform the job we have asked them to do. To protect your health information, however, we require our business associates to appropriately safeguard your information.
Appointment Reminders. We may use and disclose Information in your medical record to contact you as a reminder that you have an appointment at Community Chiropractic & Wellness Center. We will text or email you before your appointment and leave an appointment reminder. However, you may request that we provide such reminders only in a certain way or only at a certain place. We will endeavor to accommodate all reasonable requests.
Release to Family/Friends. Our health professionals, using their professional judgment, may disclose to a family member, other relative, close personal friend or any other person you identify, your health information to the extent it is relevant to that person’s involvement in your care or payment related to your care. We will provide you with an opportunity to object to such a disclosure whenever we practicably can do so. We may disclose the health information of minor children to their parents or guardians unless such disclosure is otherwise prohibited by law.
Your Health Information Rights
The following are statements of your rights with respect to your protected health information.
Right to Obtain a Paper Copy of This Notice: You have the right to a paper copy of this Notice of Privacy Practices at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy.
Right to Inspect and Copy:You have the right to inspect and copy medical information that may be used to make decisions about your care. Usually, this includes medical and billing records, but does not include psychotherapy notes. You have a right to information that is stored electronically that is not in EHR software, including information stored in MS Word, Excel, PDF, plain text and other electronic formats. To inspect and copy medical information, you must submit a written request to our privacy officer. We will supply you with a form for such a request. If you request a copy of your medical information, we may charge a reasonable fee for the costs of labor, postage, and supplies associated with your request. We may not charge you a fee if you require your medical information for a claim for benefits under the Social Security Act or any other state or federal needs‐based benefit program. If your medical information is maintained in an electronic health record, you also have the right to request that an electronic copy of your record be sent to you or to another individual or entity. We may charge you a reasonable cost based fee limited to the labor costs associated with transmitting the electronic health record. You have a right to have this information with-in 30 days of receipt of your request.
Right to Amend: If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as we retain the information. To request an amendment, your request must be made in writing and submitted to our privacy officer. In addition, you must provide a reason that supports your request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
• was not created by us;
• is not part of the medical information kept by or for Paul Eckley, D.C.;
• is not part of the information which you would be permitted to inspect and copy; or
• is accurate and complete.
If we deny your request for amendment, you may submit a statement of disagreement. We may reasonably limit the length of this statement. Your letter of disagreement will be included in your medical record, but we may also include a rebuttal statement.
Right to an Accounting of Disclosures: You have the right to request an accounting of disclosures of your health information made by us. In your accounting, we are not required to list certain disclosures, including:
• disclosures made for treatment, payment, and health care operations purposes or disclosures made incidental to treatment, payment, and health care operations, however, if the disclosures were made through an electronic health record, you have the right to request an accounting for such disclosures that were made during the previous 3 years;
• disclosures made pursuant to your authorization;
• disclosures made to create a limited data set;
• disclosures made directly to you.
To request an accounting of disclosures, you must submit your request in writing to our privacy officer. Your request must state a time period which may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you would like the accounting of disclosures (for example, on paper or electronically by email). The first accounting of disclosures you request within any 12-month period will be free. For additional requests within the same period, we may charge you for the reasonable costs of providing the accounting of disclosures. We will notify you of the costs involved and you may choose to withdraw or modify your request at that time, before any costs are incurred. Under limited circumstances mandated by federal and state law, we may temporarily deny your request for an accounting of disclosures.
Right to Request Restrictions: You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment, or health care operations. You also have the right to request a limit on the medical information we communicate about you to someone who is involved in your care or the payment for your care. You have a right to restrict certain disclosures of Protected Health Information to a health plan where you have paid out of pocket in full for the healthcare item or service. As noted above, we are not required to agree to your request. If we do agree, we will comply with your request unless the restricted information is needed to provide you with emergency treatment. To request restrictions, you must make your request in writing to our privacy officer. In your request, you must tell us what information you want to limit, whether you want to limit our use, disclosure, or both and to whom you want the limits to apply.
Right to Request Confidential Communications: You have the right to request that we communicate with you about healthcare matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by e‐mail. To request confidential communications, you must make your request in writing to our privacy officer. We will accommodate all reasonable requests.
Right to Receive Notice of a Breach: We are required to notify you by first class mail or by email (if you have indicated a preference to receive information by e‐mail), of any breaches of Unsecured Protected Health Information as soon as possible, but in any event, no later than 60 days following the discovery of the breach. “Unsecured Protected Health Information” is information that is not secured through the use of a technology or methodology identified by the Secretary of the U.S. Department of Health and Human Services to render the Protected Health Information unusable, unreadable, and undecipherable to unauthorized users.
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint. To file a complaint with us, contact our privacy officer at the address listed above. All complaints must be submitted in writing and should be submitted within 180 days of when you knew or should have known that the alleged violation occurred.
We are required by law to maintain the privacy of, and provide individuals with, this notice of our legal duties and privacy practices with respect to protect health information. We are also to abide by the terms of the notice currently in effect. If you have any questions in reference to this form, please ask to speak with our HIPAA Compliance Officer in person or by phone at our main phone number.
Furthermore, CommunityChiroWellness.com ("CCW") is owned and operated by Paul Eckley, D.C. The following website terms and conditions of use ("Terms") contain the terms and conditions upon which CCW is willing to provide you access to and use of this website and all related pages, information, materials and services (collectively, the "Site") and governs your use of services (collectively, the "Services") available through the Site. These terms form a contract between you and CCW. If you do not agree to be bound by these terms, you may not access or use the Site or Services. Use of the Site or use of the Services indicates your acceptance of these Terms.
CCW does not provide medical advice or prescription drug therapy recommendations. The Site and the Services may not contain all information that is applicable to your personal conditions or circumstances. The Site and Services are not intended for diagnosis and should not be used as a substitute for consultation with a physician or other healthcare provider. If you suspect you may have a medical problem, promptly seek the care of a physician or healthcare provider. You should contact your physician to determine whether any of the services are appropriate for your use if you have a medical problem before using any of the services.
Any information supplied through the Site or the Services, in any manner or medium, is not intended to, and does not constitute medical, legal or other professional
advice or create a professional relationship between CCW and you, and does not create any medical privacy interests.
Claims and statements made on the Site about specific nutrients or products have not been evaluated by the FDA (Food and Drug Administration). Dietary and nutritional supplements are not intended to diagnose, treat, cure or prevent disease. You should consult with a qualified healthcare professional or physician before beginning any diet, exercise or supplementation program.
You may only use this Site if you are at least 18 years of age. By accessing any portion of the Site, you have a limited license to use the Site and Services, including the limited right to view, bookmark, download and print, for your noncommercial, personal use and information only, those pages of the Site that interest you, subject to any other terms and conditions of use in these Terms or on the Site. These Terms cannot be waived or modified by any oral communications between you and CCW.
CCW reserves the right, to change, delete, or update the Terms or other policies that govern use of the Site at its discretion, at any time, for any reason, without notice, including the right to terminate the Services or any part of the Services. Any amendments and modifications by CCW will be prospective only, and unless otherwise provided in this Agreement, will be effective upon being posted on the Site. CCW encourages you to review these Terms periodically for updates and changes. Your continued access or use of the Site shall be deemed acceptance of all changes.
CCW owns all of the content, materials, and other intellectual property related to the Site and the Services, including without limit all text, graphics, photographs, music, data, images, audio and video clips, software, names, button icons, logos, images, designs, titles, words or phrases, page headers, service names, trademarks, patents, and copyrights (collectively, “Materials”). You have no rights to the Materials, except as expressly set forth in these Terms. Any use of the Materials, except as permitted by these Terms, is expressly prohibited.
For your general informational use only, CCW may provide access to third party websites. These links will allow you to leave the Site. The linked sites are not under the control of CCW and CCW is not responsible for the contents of any linked site. By providing access to other websites, CCW is not recommending or supporting any third party, is not recommending the purchase or sale of any products or services of a third party, and is not endorsing or acknowledging that it is affiliated with any website's sponsoring organization.
CCW is not obligated to maintain, verify, update or post any corrections to such third party information for any reason. Nothing in the Site referencing any third parties with whom CCW conducts business, and nothing in these Terms, shall be deemed to create any agency relationship, affiliation, or sponsorship among CCW and such third parties or you, or make the third parties or you partners or joint venturers with CCW, or otherwise provide you or any third parties with any rights to act on CCW's behalf. CCW does not represent or guarantee the truthfulness, accuracy, completeness, timeliness, authorship, suitability of content, or reliability of communications posted by third parties, nor does CCW endorse any opinions expressed by users or any third parties using the Site. Consequently, you agree that CCW does not guarantee, and is not liable to you for any third party content.CCW values the privacy of each user who accesses his website. It has adopted the following policy ("Policy”) to disclose data collection and disclosure policies and practices for this website and all related web pages (the “Site”).
CCW collects personal information from users only on a voluntary basis. When requesting information from the Site, we ask each user to provide items such as the user's name, address, e-mail address, telephone number and facsimile number.
We use your personal information to provide certain services you request through the Site, to operate and improve the Site, to improve existing or introduce new services, and
to create a positive user experience. From time-to-time, we may also use information we gather to inform you of new products or services; however you may opt-out of such
communications if you prefer not to receive them. You may also opt out of any opt-in email lists to which you subscribed. To opt-out of any such email communications, please follow
the opt-out instructions in the email or send your request to opt-out via email to CCW at [email protected]
We will use telephone numbers to contact you with information only when necessary to fulfill your request for information or services.
Regardless of whether you register with the Site, CCW collects non-personal and anonymous information from all our users to be used in an aggregate fashion. This information helps us to determine how he can create a better experience for our users. Accordingly, CCWcollects system-related information (such as an IP address, browser type, operating system type, and pages accessed) to be used for system administration purposes, to help diagnose problems with computer servers, to monitor traffic patterns, to determine which services are used most frequently, and to assess site usage.
CCW does not sell or rent your personal information to third parties; however, CCW may share your personal information with third parties as explained in this Policy and as further described in our Notice of Privacy Practices.
To provide information or services you request, CCW may share your personal information with third parties in an effort to satisfy your request. For example, if you wish to purchase services through the Site, we may share your personal information with suppliers so that your purchase can be processed. We may also disclose your personal information to entities employed to perform functions on our behalf.
If CCW ownership is transferred, whether by merger, consolidation or purchase of a substantial portion of assets, CCW may disclose and transfer your personal information to such third party. In addition, if CCW becomes the subject of a bankruptcy or insolvency proceeding, whether voluntary or involuntary, we or the trustee in bankruptcy may sell, assign, license or otherwise transfer your personal information in a transaction approved by the appropriate court.
CCW may disclose your personal information to third parties when we believe, in good faith and in our sole discretion, that such disclosure is reasonably necessary to: (a) enforce or apply the terms of this terms and conditions of this Site; (b) comply with legal or regulatory requirements; (c) protect the rights, property or safety of CCW, our users or other third parties; or (d) prevent a crime or protect national security.
CCW may disclose de-identified aggregate information to its clients, business partners, merchants, advertisers, potential advertisers, investors, potential buyers and other third parties if he deems such disclosure, in its own discretion, to have sound business reasons or justification.
CCW saves your personal information in a secure environment so that you can easily use our services upon return visits. CCW may retain information we gather about you indefinitely.
As a security precaution, all personal information is kept on computers with firewalls to help prevent intruders from gaining access to such information. Although CCW has implemented various measures to help protect your information, no technical measures are guaranteed to completely prevent unauthorized access, use, or disclosure, and CCW makes no such guarantees.
CCW does not currently use “cookies” on the Site, although they may be used in the future. If used, “cookies” will be used only for the convenience of our users and to enhance your experience using the Site. A cookie is a small text file that is recorded on your hard drive by a web page server. It is not used to deliver viruses or other harmful programs to your computer. Rather, cookies enable CCW to recognize a user Additionally, cookies allow CCW to monitor traffic patterns and site usage, which help make the Site more useful.
Please note that most browsers can be set to accept or decline cookies. You also may be able to modify your browser setting to notify you each time a cookie is created and permit you to accept or decline cookies on an individual basis or to accept cookies from websites that meet certain disclosure and use specifications. However, please be advised that declining cookies may hinder performance of the Site and thereby negatively impact your experience using the Site if cookies are ever used on the Site.
The Site is not intended for children. CCW does not knowingly or specifically collect personal information from users under 18 years of age or authorize such users to use the Site or Services. However, adults with custodial care of a minor may use the Site for obtaining information on behalf of the minor. If CCW becomes aware that it has collected personal information from a user under 18 years of age, it retains the right to take steps to delete such information from his database.
We reserve the right to change this Policy at any time and for any reason. In particular, CCW may modify this Policy from time-to-time to reflect changes in the way information is collected, used or disclosed or to reflect changes in privacy laws, regulations and/or industry standards. We reserve the right to make the revised policy effective for information we already have about you as well as information received in the future. Accordingly, we encourage you to review this Policy from time to time in the future. Your continued use of the Site following changes to this Policy indicates your acceptance of those changes.If you have questions regarding these Terms, please contact Dr. Eckley at:
Community Chiropractic & Wellness Center
2352 S. Commerce Rd.
Walled Lake, MI 48390